Massive Pilomatrixoma of the Scalp: A Case Report.

Pilomatrixoma, also called epithelioma of Malherbe, is a benign neoplasm derived from hair follicle matrix cells. It usually presents as a solitary mass in the head and neck region and is more frequent in children and young adults, females, and the Caucasian population. Lesions equal to or greater than 5 cm are categorized as giant pilomatrixomas. We present a case of a 75-year-old female, with no known medical history, who was brought to the emergency department (ED) after falling on the street. She had a giant soft head tissue tumor, severe anemia due to intralesional chronic small hemorrhages and folates and cobalamin deficiencies, and delirant speech. The anatomopathological result of the biopsy of the tumor revealed to be a pilomatrixoma. The patient was then referred to plastic surgery, with complete excision of the tumor. After surgery, she was transferred to the psychiatric team, who assumed the delirant speech to be in the context of schizophrenia. She was discharged four months after admission.

Biocompatibility and inflammatory response of silver tungstate, silver molybdate, and silver vanadate microcrystals.

Silver tungstate (α-Ag2WO4), silver molybdate (ß-Ag2MoO4), and silver vanadate (α-AgVO3) microcrystals have shown interesting antimicrobial properties. However, their biocompatibility is not yet fully understood. Cytotoxicity and the inflammatory response of silver-containing microcrystals were analyzed in THP-1 and THP-1 differentiated as macrophage-like cells, with the alamarBlue™ assay, flow cytometry, confocal microscopy, and ELISA. The present investigation also evaluated redox signaling and the production of cytokines (TNFα, IL-1ß, IL-6, and IL-8) and matrix metalloproteinases (MMP-8 and -9). The results showed that α-AgVO3 (3.9 µg/mL) did not affect cell viability (p > 0.05). α-Ag2WO4 (7.81 µg/mL), ß-Ag2MoO4 (15.62 µg/mL), and α-AgVO3 (15.62 µg/mL) slightly decreased cell viability (p ≤ 0.003). All silver-containing microcrystals induced the production of O2 - and this effect was mitigated by Reactive Oxygen Species (ROS) scavenger and N-acetylcysteine (NAC). TNFα, IL-6 and IL-1ß were not detected in THP-1 cells, while their production was either lower (p ≤ 0.0321) or similar to the control group (p ≥ 0.1048) for macrophage-like cells. The production of IL-8 by both cellular phenotypes was similar to the control group (p ≥ 0.3570). The release of MMP-8 was not detected in any condition in THP-1 cells. Although MMP-9 was released by THP-1 cells exposed to α-AgVO3 (3.9 µg/mL), no significant difference was found with control (p = 0.7). Regarding macrophage-like cells, the release of MMP-8 and -9 decreased in the presence of all microcrystals (p ≤ 0.010). Overall, the present work shows a promising biocompatibility profile of, α-Ag2WO4, ß-Ag2MoO4, and α-AgVO3 microcrystals.

Virulence factors and antimicrobial resistance of Escherichia coli isolated from commercialized fresh cheese in the south of Espírito Santo.

Cheeses are dairy products that can potentially contain a diverse range of harmful bacteria that could be consumed by humans, including the enteric pathogen Escherichia coli. This study aimed to characterize the presence of total coliforms, assess the antimicrobial susceptibility profiles of the main commercial antimicrobial classes and biocides, and evaluate the ability of 50 E. coli isolates obtained from fresh cheese sold in the southern region of Espírito Santo, Brazil, to produce biofilms. The counts of total coliforms + E. coli obtained averages of (A) 7.22 × 106 CFU/g, (B) 9.35 × 107 CFU/g, and (C) 1.16 × 106 CFU/g for different brands. All isolates were capable of forming biofilms, with 8%, 76%, and 16% of these isolates presenting high, moderate, and low adherence in biofilm formation, respectively. Most strains showed inhibition halos for the biocides chlorhexidine digluconate 2% (16 mm ± 4.34), iodopovidone 10% (7.14 mm ± 0.36), and sodium hypochlorite 2% (7.12 mm ± 0.33). Out of the 50 strains, 21 (42%) were resistant to at least one of the antimicrobials. Regarding the multiple resistance index, 3 (6%) strains were resistant to 3 or more antimicrobial classes. Furthermore, 2 (4%) were extended-spectrum beta-lactamases producers. Resistance to ampicillin and amoxicillin was observed in 20% and 40% of the strains, respectively. In contrast, gentamicin was the most effective antimicrobial, with a sensitivity rate of 100%. The findings indicate that E. coli present in fresh cheese may possess unique physiological characteristics that could be associated with their persistence, virulence, and multidrug resistance. These results raise significant public health concerns since contaminated food can pose risks to consumers' health, emphasizing the importance of reinforcing hygienic-sanitary controls at all stages of production.

Lymphomatoid Papulosis "Type E" Affecting the Palate: A Detailed Case Report and Review of Literature.

ABSTRACT: Lymphomatoid papulosis (LyP) belongs to the spectrum of primary cutaneous CD30 + lymphoproliferative disorders, characterized by chronic, recurrent, self-healing papules, small nodules, or ulcers. The clinicopathological features of LyP can mimic overt lymphomas. To date, about 27 intraoral LyP cases have been reported. Of them, only 2 cases were diagnosed as angioinvasive LyP (type E). Herein, we report a 24-year-old Brazilian man who presented a large ulcerated lesion on the hard palate with rapid evolution. Remarkably, there was no involvement of the skin or other mucous membranes. Microscopy revealed a lymphoid infiltrate constituted by medium-sized to large atypical cells, with angiocentric and angiodestructive features. The atypical cells showed immunopositivity for CD3, CD8, CD30, CD56, granzyme B, perforin, and focally for MUM1/IRF4. Ki-67 highlighted almost all atypical lymphoid cells, whereas EBER1/2 was negative. After 2 months of follow-up, the lesion healed completely. Although rare, LyP type E should be included in the differential diagnosis of oral ulcers.

Role of Caveolin-1 in Sepsis - A Mini-Review.

Sepsis is a generalized disease characterized by an extreme response to a severe infection. Moreover, challenges remain in the diagnosis, treatment and management of septic patients. In this mini-review we demonstrate developments on cellular pathogenesis and the role of Caveolin-1 (Cav-1) in sepsis. Studies have shown that Cav-1 has a significant role in sepsis through the regulation of membrane traffic and intracellular signaling pathways. In addition, activation of apoptosis/autophagy is considered relevant for the progression and development of sepsis. However, how Cav-1 is involved in sepsis remains unclear, and the precise mechanisms need to be further investigated. Finally, the role of Cav-1 in altering cell permeability during inflammation, in sepsis caused by microorganisms, apoptosis/autophagy activation and new therapies under study are discussed in this mini-review.

Inactivation of SARS-CoV-2 by a chitosan/α-Ag2WO4 composite generated by femtosecond laser irradiation.

In the current COVID-19 pandemic, the next generation of innovative materials with enhanced anti-SARS-CoV-2 activity is urgently needed to prevent the spread of this virus within the community. Herein, we report the synthesis of chitosan/α-Ag2WO4 composites synthetized by femtosecond laser irradiation. The antimicrobial activity against Escherichia coli, Methicilin-susceptible Staphylococcus aureus (MSSA), and Candida albicans was determined by estimating the minimum inhibitory concentration (MIC) and minimal bactericidal/fungicidal concentration (MBC/MFC). To assess the biocompatibility of chitosan/α-Ag2WO4 composites in a range involving MIC and MBC/MFC on keratinocytes cells (NOK-si), an alamarBlue™ assay and an MTT assay were carried out. The SARS-CoV-2 virucidal effects was analyzed in Vero E6 cells through viral titer quantified in cell culture supernatant by PFU/mL assay. Our results showed a very similar antimicrobial activity of chitosan/α-Ag2WO4 3.3 and 6.6, with the last one demonstrating a slightly better action against MSSA. The chitosan/α-Ag2WO4 9.9 showed a wide range of antimicrobial activity (0.49-31.25 µg/mL). The cytotoxicity outcomes by alamarBlue™ revealed that the concentrations of interest (MIC and MBC/MFC) were considered non-cytotoxic to all composites after 72 h of exposure. The Chitosan/α-Ag2WO4 (CS6.6/α-Ag2WO4) composite reduced the SARS-CoV-2 viral titer quantification up to 80% of the controls. Then, our results suggest that these composites are highly efficient materials to kill bacteria (Escherichia coli, Methicillin-susceptible Staphylococcus aureus, and the yeast strain Candida albicans), in addition to inactivating SARS-CoV-2 by contact, through ROS production.

Antifungal Activity and Biocompatibility of α-AgVO3, α-Ag2WO4, and ß-Ag2MoO4 Using a Three-Dimensional Coculture Model of the Oral Mucosa.

Fungal infections have become a major concern in the medical community, especially those caused by Candida spp. Within this species, Candida albicans stands out for being an opportunistic commensal fungus that can cause superficial and invasive infections. Current antifungal therapy involves the local and/or systemic use of drugs such as azoles, polyenes, and echinocandins. These antifungals are based on highly specific target sites, and the development of resistance may occur with changes in the enzymatic pathways that serve as the drug targets. Thus, the development of new antifungal drugs is highly recommended to prevent drug resistance. The present investigation evaluated the antifungal activity of silver-containing microcrystals such as silver vanadate (α-AgVO3), silver tungstate (α-Ag2WO4), and silver molybdate (ß-Ag2MoO4). In addition to having antimicrobial activity, such compounds should not cause damage to underlying tissues. Thus, to better assess the biocompatibility of new compounds, a new three-dimensional (3D) coculture model involving three cell lines was developed. The validation of the model was based on fluorescent markers and confocal laser microscopy. The biocompatibility of silver-containing microcrystals was evaluated by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. 3D coculture was infected with C. albicans biofilm and challenged with α-AgVO3, α-Ag2WO4, and ß-Ag2MoO4. The action of microcrystals on C. albicans biofilm was evaluated by colony-forming units (CFU/ml) and LIVE/DEAD staining. In addition, production of proinflammatory cytokines interleukin 6 (IL-6), IL-8, IL-1ß, and tumor necrosis factor α (TNF-α) was measured by cytometric bead array kit using flow cytometry. The 3D coculture model described here proved to be adequate to assess both the biocompatibility of the new materials and the infectious processes. Regarding the biocompatibility of the microcrystals, only α-AgVO3 (15.62 µg/ml) showed a decrease in cell viability. The antibiofilm activity of α-Ag2WO4 was similar to that of the standard drug (fluconazole). Although α-Ag2WO4 was able to induce the production of IL-6, IL-8, and IL-1ß, no differences in cytokine production were observed between noninfected and infected models treated with this microcrystal. ß-Ag2MoO4 inhibits the production of TNF-α in the infected model; however, it showed no antibiofilm activity. Based on the biocompatibility and antifungal findings, α-Ag2WO4 is a promising material for treating C. albicans infection.

Herbicides That Target Acetohydroxyacid Synthase Are Potent Inhibitors of the Growth of Drug-Resistant Candida auris.

Acetohydroxyacid synthase (AHAS, EC 2.2.1.6), the first enzyme in the branched chain amino acid biosynthesis pathway, is the target for more than 50 commercially available herbicides, and is a promising target for antimicrobial drug discovery. Herein, we have expressed and purified AHAS from Candida auris, a newly identified human invasive fungal pathogen. Thirteen AHAS inhibiting herbicides have Ki values of <2 µM for this enzyme, with the most potent having Ki values of <32 nM. Six of these compounds exhibited MIC50 values of <1 µM against C. auris (CBS10913 strain) grown in culture, with bensulfuron methyl (BSM) being fungicidal and the most potent (MIC50 of 0.090 µM) in defined minimal media. The MIC50 value increases to 0.90 µM in media enriched by the addition of branched-chain amino acids at the expected concentration in the blood serum. The sessile MIC50 for BSM is 0.6 µM. Thus, it is also an excellent inhibitor of the growth of C. auris biofilms. BSM is nontoxic in HEK-293 cells at concentrations >100 µM and thus possesses a therapeutic index of >100. These data suggest that targeting AHAS is a viable strategy for treating C. auris infections.

Antifungal activity and biocompatibility of α-AgVO3 microcrystals: A promising material against oral Candida disease.

The number of studies on microcrystals containing silver has increased in recent decades. Among the silver-containing microcrystals, α-AgVO3 has gained prominence owing to its polymorphism that allows it to exert interesting antimicrobial activity against pathogenic microorganisms. The aim of this study was to evaluate the antifungal activity and cytotoxicity of three different α-AgVO3 microcrystals when in solution. α-AgVO3 microcrystals were synthesized using the co-precipitation method at three different temperatures (10 °C, 20 °C, and 30 °C), and then characterized by X-ray diffraction and scanning electron microscopy. The antifungal activity of α-AgVO3 microcrystals against Candida albicans was determined by estimating the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC). Fluorescence images were obtained to confirm antifungal concentrations. To assess the biocompatibility of microcrystals applied at MIC and MFC on keratinocytes cells (NOK-si), an Alamar Blue assay, scanning electron microscopy, and a DNA gel integrity test were carried out. The quantitative and qualitative results showed that, regardless of the co-precipitation method used to synthetize α-AgVO3 microcrystals, C. albicans growth was visibly inhibited at 3.9 µg/mL (MIC) and completely inhibited at 15.62 µg/mL (MFC). The cytotoxic and genotoxic outcomes revealed that the MIC and MFC concentrations did not affect NOK-si cell morphology, proliferation, or DNA integrity. The search for new antimicrobial materials has been the focus of the research community recently because of increases in microbial resistance. The findings reported herein demonstrate a novel antifungal and non-cytotoxic material that could be used in biomedical and dental applications.

Mechanism of Antibacterial Activity via Morphology Change of α-AgVO3: Theoretical and Experimental Insights.

The electronic configuration, morphology, optical features, and antibacterial activity of metastable α-AgVO3 crystals have been discussed by a conciliation and association of the results acquired by experimental procedures and first-principles calculations. The α-AgVO3 powders were synthesized using a coprecipitation method at 10, 20, and 30 °C. By using a Wulff construction for all relevant low-index surfaces [(100), (010), (001), (110), (011), (101), and (111)], the fine-tuning of the desired morphologies can be achieved by controlling the values of the surface energies, thereby lending a microscopic understanding to the experimental results. The as-synthesized α-AgVO3 crystals display a high antibacterial activity against methicillin-resistant Staphylococcus aureus. The results obtained from the experimental and theoretical techniques allow us to propose a mechanism for understanding the relationship between the morphological changes and antimicrobial performance of α-AgVO3.

Effects of Image Compression on Linear Measurements of Digital Panoramic Radiographs.

This study aimed to evaluate the accuracy of panoramic radiographs obtained by digital system based on charge coupled device (CCD) and a phosphor storage plate (PSP) system with two different file formats, JPEG irreversible type and BMP. Linear measurements of artificial bony defects were made in dry mandibles with a digital caliper. Measures of digital panoramic radiographs were taken in ImageJ(r) software. Each measurement was performed twice by an experienced examiner. The intra-rater agreement was considered very strong (Pearson's correlation coefficient of 0.97). There was no significant difference between the linear measurements of dry mandibles, considered the gold standard, in relation to measurements obtained from digital radiographs (p=0.47). The error of these measures for the CCD was 1.04 mm (9.97%) for JPEG images and 1.03 mm (9.99%) for those with BMP format. For the PSP images, these values were 1.48 mm (14.94%) and 1.43 mm (14.43%), respectively. Although there was no statistical difference between the images with JPEG and BMP format, for both digital systems (p=1.00 for CCD and p=0.98 for PSP system), errors made on radiographs obtained by PSP system were significantly higher than those of CCD (p<0.05). The size of the files saved in JPEG was also significantly lower (p=0.005) compared with the files saved in BMP. It may be concluded that the digital radiographs, both saved in JPEG and BMP formats, are accurate, regardless the used digital system, and JPEG images are more suitable for teleradiology.

Effects of Image Compression on Linear Measurements of Digital Panoramic Radiographs

Abstract This study aimed to evaluate the accuracy of panoramic radiographs obtained by digital system based on charge coupled device (CCD) and a phosphor storage plate (PSP) system with two different file formats, JPEG irreversible type and BMP. Linear measurements of artificial bony defects were made in dry mandibles with a digital caliper. Measures of digital panoramic radiographs were taken in ImageJ(r) software. Each measurement was performed twice by an experienced examiner. The intra-rater agreement was considered very strong (Pearson's correlation coefficient of 0.97). There was no significant difference between the linear measurements of dry mandibles, considered the gold standard, in relation to measurements obtained from digital radiographs (p=0.47). The error of these measures for the CCD was 1.04 mm (9.97%) for JPEG images and 1.03 mm (9.99%) for those with BMP format. For the PSP images, these values were 1.48 mm (14.94%) and 1.43 mm (14.43%), respectively. Although there was no statistical difference between the images with JPEG and BMP format, for both digital systems (p=1.00 for CCD and p=0.98 for PSP system), errors made on radiographs obtained by PSP system were significantly higher than those of CCD (p<0.05). The size of the files saved in JPEG was also significantly lower (p=0.005) compared with the files saved in BMP. It may be concluded that the digital radiographs, both saved in JPEG and BMP formats, are accurate, regardless the used digital system, and JPEG images are more suitable for teleradiology.

Resumo Este estudo teve como objetivo avaliar a acurácia de radiografias panorâmicas digitais obtidas por sistema digital baseado em dispositivo acoplador de carga (DAC) e por sistema de placa de fósforo (PF) com duas diferentes extensões de arquivo (JPEG e BMP, sendo o primeiro do tipo compactador irreversível). Medidas lineares de defeitos ósseos foram realizadas em mandíbulas secas com paquímetro digital. As medidas correspondentes nas radiografias panorâmicas digitais foram realizadas no software ImageJ(r). As medidas foram realizadas duas vezes por um examinador. A concordância intraexaminador foi considerada muito forte (coeficiente de correlação de Pearson de 0,97). Não houve diferença significante entre as medidas lineares das mandíbulas secas, consideradas padrão-ouro, em relação às medidas obtidas das radiografias digitais (p=0,47). Os erros absolutos e relativos dessas medidas para o DAC foram de 1,04 mm (9,97%) para as imagens JPEG e de 1,03 mm (9,99%) para aquelas com extensão BMP. Para o sistema digital com PF esses valores foram de 1,48 mm (14,94%) e 1,43 mm (14,43%), respectivamente. Apesar de não ter havido diferença estatística entre as imagens com extensão JPEG e BMP, para ambos os sistemas digitais (p=1,00 para DAC e p=0,98 para a PF), os erros das medidas realizadas nas radiografias obtidas pelo sistema de PF foram significativamente maiores que os erros do DAC (p<0,05). O tamanho dos arquivos salvos em JPEG também foram significativamente menores (p=0,005) em comparação com os arquivos salvos em BMP. Pode-se concluir que as radiografias digitais tanto com extensão JPEG quanto BMP são acuradas, independente do sistema digital utilizado e as imagens salvas em JPEG são mais indicadas em telerradiologia.

Association between radiographic features and cell proliferation in keratocystic odontogenic tumor / Asociación entre las características radiográficas y la proliferación celular en el tumor odontogénico queratoquístico

The radiographic features of an intraosseous lesion are usually associated with the biological behavior of the tumor. In view of the fact that the growth and behavior of keratocystic odontogenic tumors (KCOT) is mainly associated with the proliferation of the cystic epithelium, the objective of the present study was to evaluate the relationship between cell proliferation markers and radiographic features of this tumor. Thirty-seven radiographs of KCOT obtained from 30 patients were scanned and evaluated on a monitor. Sections were submitted to immunohistochemistry for Ki-67, p63, and p53 proteins on an EnVision system. Thirty-one KCOTs were observed in the posterior of the mandible, and the unilocular aspect was predominant (n= 26). Nineteen KCOTs distorted the mandibular canal and 11 displaced teeth. Satellite cysts were associated with a multilocular aspect (P= 0.016). p53 was in KCOTS with diffuse margins (p=0.049), p63 with NBCCS (p=0.049) KOT and higher KI-67 positive cells was observed in KCOTs presenting distortion of the mandibular canal (p=0.042). The distribution of Ki-67, p63, and p53 positive cells was similar between KCOTs with uni- and multilocular aspects. The results of the present study suggest that cell proliferation in KCOT contributes to the radiographic features of this tumor.

Las características radiográficas de una lesión intraósea se asocian generalmente con el comportamiento biológico del tumor. Debido a esto, el crecimiento y comportamiento de los tumores odontogénicos queratoquísticos se asocian principalmente con la proliferación del epitelio quístico. El objetivo del estudio fue evaluar la relación entre los marcadores de proliferación celular y las características radiológicas de este tumor. Se escanearon y evaluaron 37 radiografías de tumores odontogénicos queratoquísticos obtenidos de 30 pacientes y las secciones de sus biopsias fueron sometidas a evaluación inmunohistoquímica para las proteíneas Ki-67, p63 y p53 en un sistema Envision. Se observaron 31 tumores odontogénicos queratoquísticos en el área posterior de la mandíbula, con predominio del aspecto unilocular (n= 26). Diecinueve tumores odontogénicos queratoquísticos distorsionaron el canal mandibular y se observaron 11 dientes desplazados. Los quistes satélites se asociaron con el aspecto multilocular (P= 0,016). La distribución de células positivas para Ki-67, p63 y p53 fue similar entre tumores odontogénicos queratoquísticos con aspectos uniformes y multiloculares, y no estaban relacionadod con la distorsión del canal mandibular (P>0,05) o con el desplazamiento del diente (P>0,05). Los resultados del presente estudio sugieren que la proliferación celular en tumores odontogénicos queratoquísticos contribuye a las características radiográficas de este tumor.